Treatment of endometrioma for improving fertility
Treatment of endometrioma for improving fertility
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DOI：
10.1016/j.ejogrb.2016.02.035
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发表时间：
2017-02-01
影响因子：
2.6
通讯作者：
Ferrero, Simone
中科院分区：
文献类型：
--
作者：
Maggiore, Umberto Leone Roberti;Gupta, Janesh Kumar;Ferrero, Simone
子宫内膜异位症是子宫内膜异位症的常见临床表现。子宫内膜异位瘤如何影响女性的生育能力是有争议的。本文综述了子宫内膜异位瘤本身及其手术治疗对卵巢生理、卵巢储备、自然受孕和妊娠结局以及IVF/ICSI结果的影响。根据目前的证据，尽管子宫内膜异位瘤周围的卵巢皮层可能存在生物学上的有害影响，并对卵巢正常生理机能造成损害，但子宫内膜异位瘤本身的临床影响并没有显著改变。有一个可以忽略不计的有害影响卵巢储备与自发排卵不受损害。相反，手术切除子宫内膜异位瘤会减少卵巢储备，这是由AMH水平测量的。调查子宫内膜异位瘤本身及其手术治疗对需要体外受精/ICSI的妇女的影响的研究表明，子宫内膜异位瘤妇女和对照组的着床率、临床妊娠率和活产率相似。2016爱思唯尔爱尔兰有限公司版权所有。
Endometrioma is a frequent clinical manifestation of endometriosis. It is controversial how endometriomas may affect women's fertility. This review addresses: the impact of the endometrioma per se and of its surgical treatment on ovarian physiology, on the ovarian reserve, on spontaneous conception and pregnancy outcomes, and on IVF/ICSI outcomes.Based on current evidence, although there are plausible biological detrimental effects on the ovarian cortex surrounding the endometrioma and an impairment of the normal ovarian physiology, the clinical impact of the endometrioma per se is not significantly altered. There is a negligible detrimental effect on ovarian reserve with spontaneous ovulation not being impaired. Conversely, surgical excision of an endometrioma reduces ovarian reserve as measured by AMH levels. Studies investigating the impact of the endometrioma per se and of its surgical treatment in women requiring IVF/ICSI show similar implantation rates, clinical pregnancy rates and live birth rates between women with endometrioma and controls. (C) 2016 Elsevier Ireland Ltd. All rights reserved.